Surgery can lead to long-term reduction in stroke risk

Science | Health 24 Sep 10 Successful surgery for narrowed arteries in the neck halves the risk of having a stroke over the next 5 years, and benefit persists for at least 10 years, an Oxford-led study has shown. However, operating on the main arteries that take blood to the brain involves about a 3% risk of causing an immediate stroke. Otherwise healthy patients who are discovered to have substantial narrowing of either of the main arteries in the neck are at an increased risk of having a stroke in the future. An operation, called a carotid endarterectomy (CEA), can remove the fatty deposits narrowing the artery, but the procedure itself causes some immediate risk of stroke or death. In this long-running randomised trial, the researchers assessed whether the benefits of successful CEA procedures in reducing the likelihood of a stroke over the next 5 or 10 years balanced out the immediate risks of surgery in these patients. The researchers conclude that there is likely to be net benefit from operating on those in good health under 75 years old, as long as the surgical risks remain low. Among older patients the immediate risk of surgery may outweigh the long-term benefit, however.